Saturday, May 3, 2014

It’s not too late to redeem health services

By Lukoye Atwoli
Sunday Nation 27 April 2014

The Kenya Medical Association held its 42nd Annual Scientific
Conference this past week where it came to light that health services
are in dire straits. The Medical Board gave alarming statistics
that showed a huge discrepancy between the number of doctors trained in
Kenya, and those currently working in the country. Obviously there is an
exodus of doctors and other health workers in search of the proverbial
“greener pastures”.

Why is this happening?

Until
a few years ago, the terms and conditions of service for doctors were
unbelievably pathetic. Following the registration of the doctors’ union
and a series of strikes, the government improved the pay packages for
health workers and developed a retention policy. For the first
time in many years, health workers started seeking change of employer
from the private sector to the public sector. Many people in far-flung
areas were for the first time in their lives able to see a doctor when
unwell.

Then came the new Constitution that devolved a portion of
health services to the counties. In a monumental misreading of the
Constitution, the national government purported to have devolved the
health sector “100 per cent”. As a result, many health workers found
themselves in the employ of county governments that had other
priorities.

In their first budgets, many county governments did
not provide funding for health workers’ pay. As a result, there are
still problems with remuneration of health workers. Many health policy
decisions are being taken as afterthoughts, without regard to the fact
that their impact often means that people could die.

A perception
has been created that health workers are against devolution of health to
the counties. This is an erroneous assertion aimed at painting health
workers as spoilt brats who do not want to be supervised in their work. Many
governors are pushing this argument, going as far as to claim that many
of those asking for pay are “ghost workers”. Some have embarked on an
ethnic audit of their health staff, and others have been encouraging
doctors to emigrate to their “home counties”.

Finally, many
doctors expect that when employed, their employer would eventually pay
for them to undergo further studies in pursuit of specialisation. The
national government has, to a large extent, facilitated this through a
scholarship programme in the Ministry of Health. Unfortunately, this
assurance is lacking in most county governments.

These are some of
the issues that are driving doctors and other health workers away from
public sector employment to the private sector and, more worryingly, to
other countries. Right from the beginning, health workers have
proposed solutions to deal with these and other emerging issues. These
suggestions have been largely ignored by the powers that be.

Happily,
political leaders at the national level are coming to the realisation
that unless urgent steps are taken, people will continue to die and
suffer from preventable causes. A parliamentary committee has
been reported arguing for the formation of a national agency to deal
with human resources for health in order to eliminate inequities and
address the welfare of health workers and the public.

One hopes
that those responsible for the health of Kenyans will take this
initiative seriously, unless they are happy with the continued
deterioration in the sector.

Dr Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine. lukoye@gmail.com